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Designated Supportive Living DESIGNATED SUPPORTIVE LIVING RESIDENT EXPERIENCE SURVEY REPORT Provincial Results September 2020 The Health Quality Council of Alberta is a provincial agency that pursues opportunities to improve patient safety and health service quality for Albertans. It surveys Albertans on their experience with patient safety and health service quality, gathers and analyzes information, monitors the healthcare system, and collaborates with Alberta Health, Alberta Health Services, health professions, academia, and other stakeholders to drive actionable improvements. Our responsibilities are set forth in the Health Quality Council of Alberta Act. DOCUMENT COPYRIGHT The Health Quality Council of Alberta holds copyright and intellectual property rights of this document. This document is licensed under a Creative Commons “Attribution-Non-Commercial-No Derivatives 4.0 International” license: http://creativecommons.org/licenses/by-nc-nd/4.0/ You may copy, distribute, or transmit only unaltered copies of the document, and only for non- commercial purposes. Attribution is required if content from this document is used as a resource or reference in another work that is created. To reference this document, please use the following citation: Health Quality Council of Alberta. Designated Supportive Living Resident Experience Survey Report. Provincial results. Calgary, Alberta, Canada: Health Quality Council of Alberta; September 2020. Please contact the Health Quality Council of Alberta for more information: [email protected], 403.297.8162. TABLE OF CONTENTS 1.0 USING THE RESULTS AND OVERVIEW OF FINDINGS ....................................................... 5 1.1 A note on how to use the results ........................................................................................................ 5 1.2 2019 Site results at a glance .............................................................................................................. 5 1.3 What are the actions for improvement? ........................................................................................... 15 2.0 BACKGROUND ...................................................................................................................... 18 2.1 Designated Supportive Living .......................................................................................................... 18 2.2 HQCA’s Designated Supportive Living Resident Experience Survey .............................................. 21 2.3 HQCA’s Designated Supportive Living Family Experience Survey .................................................. 21 3.0 SURVEY PROCESS AND METHODOLOGY ........................................................................ 22 3.1 The survey instrument ..................................................................................................................... 22 3.2 Survey sampling .............................................................................................................................. 22 3.3 Survey protocol and survey type ...................................................................................................... 22 3.4 Quantitative analytical approach ...................................................................................................... 23 4.0 2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS ................................................. 25 4.1 Overall Care Rating ......................................................................................................................... 25 4.2 Propensity to Recommend ............................................................................................................... 26 4.3 Dimension of Care: Facility Environment ......................................................................................... 27 4.4 Dimension of Care: Resident Environment ...................................................................................... 29 4.5 Dimension of Care: Choice .............................................................................................................. 31 4.6 Dimension of Care: Relationship with Employees ............................................................................ 33 4.7 Dimension of Care: Activities ........................................................................................................... 35 4.8 Dimension of Care: Meals and Dining .............................................................................................. 37 4.9 Dimension of Care: Communications ............................................................................................... 39 4.10 Dimension of Care: Care and Services ............................................................................................ 41 4.11 Dimension of Care: Employee Responsiveness .............................................................................. 43 4.12 Dimension of Care: Laundry ............................................................................................................ 45 4.13 Dimension of Care: General Satisfaction ......................................................................................... 47 4.14 Additional Care Questions ............................................................................................................... 49 5.0 SITE CHARACTERISTICS ..................................................................................................... 53 5.1 Level of care .................................................................................................................................... 53 5.2 Site size: Number of DSL spaces .................................................................................................... 54 5.3 Operator type ................................................................................................................................... 55 5.4 Site age ............................................................................................................................................ 55 5.5 Geography: Urban versus rural ........................................................................................................ 56 6.0 LIMITATIONS .......................................................................................................................... 57 7.0 APPENDICES ........................................................................................................................... 58 APPENDIX I: RESIDENT EXPERIENCE SURVEY TOOL (PAPER VERSION) ............................................ 59 APPENDIX II: SURVEY PROCESS AND METHODOLOGY ......................................................................... 68 APPENDIX III: SURVEY MODALITY ............................................................................................................. 80 APPENDIX IV: DIFFERENCES BETWEEN 2019 SURVEY AND 2016 SURVEY ......................................... 81 APPENDIX V: CRITERIA FOR SITE INCLUSION 2019 ................................................................................ 82 APPENDIX VI: 2019 RESPONDENT CHARACTERISTICS .......................................................................... 88 APPENDIX VII: 2019 SITE RESULTS ........................................................................................................... 90 APPENDIX VIII: SUMMARY OF 2019 PROVINCIAL AND ZONE-LEVEL RESPONSES TO INDIVIDUAL SURVEY QUESTIONS ................................................................................................................................ 155 APPENDIX IX: MODELLING SPECIFICS.................................................................................................... 175 APPENDIX X: DETERMINING ACTIONS FOR IMPROVEMENT ............................................................... 176 1.0 USING THE RESULTS AND OVERVIEW OF FINDINGS 1.1 A note on how to use the results The focus of this report is to describe the current state of designated supportive living (DSL) from the perspective of the residents who live at DSL sites. The results for each DSL site are compared amongst site peers within each AHS Zone, in addition to the previous survey iteration. Ultimately, these results are intended to guide reflection on performance and assist in identifying quality improvement opportunities. The key measures used to present the survey results include 11 Dimensions of Care, the Overall Care Rating (a measure of residents’ overall experience), and the Propensity to Recommend. The Dimensions of Care each represent a set of questions that share a similar theme; they influence the Overall Care Rating and can be used to identify areas of success and opportunities for improvement at DSL sites across Alberta. Other factors can contribute to residents’ experience at a site. Resident experience alone should not be used to assess site performance in the absence of other information, such as site demographics (i.e., average age of residents and percentage male/female), level-of-need of the resident population, and other quality measures such as those derived from the interRAITM Resident Assessment Instrument (RAI), complaints and concerns, accreditation results, and compliance with Continuing Care Health Service Standards (CCHSS). One option for publicly available information is the HQCA’s FOCUS on Healthcare website. It was expanded to include designated supportive living in 2019. It features 28 interactive charts that present administrative data as well as patient experience survey data about designated
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